Relapse: What You Need to Know and Do

If you care about someone who was once addicted to drugs or alcohol, you probably already worry about relapse. What will happen if he or she suffers a relapse after rehab?

As a non-addicted person, it might also be extremely difficult for you to understand why people relapse on drugs or alcohol after finally getting sober. After all, your loved one spent so much time and effort beating addiction — why do people relapse on drugs or alcohol after working so hard at getting sober?

call today learn more view our programs

The answers are complex. Addiction is a chronic disease that causes serious, long-lasting physiological, emotional and behavioral problems. It is also a condition that usually requires a commitment to lifelong care. Even the most successful-looking people who were once addicted and have been sober for years can return to chronic substance abuse.

If someone you love is in danger of returning to an addictive lifestyle, here is what you need to know, including how to handle a drug or alcohol relapse.

Lapse vs. Relapse

The first thing you need to do is figure out if the person you care about has truly suffered a relapse. It is very common for people who are recovering from a dependency on alcohol or drugs to “slip” but not return completely to addictive behavior.

For example, imagine you went to a party last night with someone who has made a commitment to sobriety. He has been doing well, but at the party one thing led to another. When you saw him later in the night, he was drinking and doing drugs. Today, when you called to check in on him, he apologized for using. He said he made a mistake, has already called his sponsor and has recommitted to sobriety.

Although we know how upsetting it is to see someone who has committed to sobriety start using drugs or alcohol again, one night of using does not mean his or her addictive behaviors have returned. It does mean that you will have to be vigilant, however.

Signs of a relapse

You are likely able to tell when your loved one is using now that you already know what to look for — lies and denials despite obvious evidence, unexplained changes in mood, changes in sleeping and eating patterns, forgetting or ignoring responsibilities. If you observe these behaviors, your loved one needs to get help now.

What Are the Warning Signs of a Relapse?

When you’re new in your recovery, relapse is all too often just around the corner. Regardless if you’ve been clean and sober for years or have just walked out of treatment, the potential for relapsing is real, and no user is ever completely safe from it.

Most users, particularly those in recovery, would agree that addiction and staying sober is a commitment that lasts a lifetime. It can be an extremely difficult choice to become clean, and frankly, it’s a lot of work staying that way.

A common thought by users — and maybe one you’re having — is that once you complete treatment and become clean, you’re fully recovered. However, recovery is much more than that. It’s a journey that is ongoing and comes with a fair share of hurdles, along with triumphs, along your recovery path.

what to do about relapse

Early Signals of a Potential Relapse

When you’re trying to figure out how to help someone who relapsed or you’re concerned that you may be relapsing, there are signals that indicate a relapse might be on its way. It’s during this time that you can take steps to address the early stages of relapse so it doesn’t happen.

You or your loved one might exhibit one or more of the following behaviors and emotions that signal a relapse is imminent:

  • Displaying anger
  • Experiencing anxiety
  • Being moody
  • Having extreme sensitivity
  • Demonstrating impatience
  • Encountering sleep problems
  • Refusing help
  • Lying
  • Isolating oneself
  • Avoiding following the recommendations of treatment
  • Reminiscing about the past
  • Realizing changes in appetite
  • Talking about relapse
  • Being around friends who they’ve used in the past with

If you’re in recovery or if your loved is in recovery, you need to recognize signs of potential relapse as soon as possible. Remember though, that if you or your loved one does relapse, it doesn’t mean failure to recover. It just means the treatment regimen should be re-evaluated.

relapse does not mean failure

Things to look out for include:

Your emotions and feelings are all over the place.

Being sober can be uncertain, new and even scary. You are used to living and behaving in a certain way. This has now changed for you considerably or is completely gone. You’re now left to manage new feelings and understand your body and emotions. This transformation may make you feel unstable to the point where a relapse is the only way you can cope and feel normal again.

Coping with everyday stressors is difficult.  

When you or your loved one is in recovery, it can be hard to live life on life’s terms. Everyday stressors that a healthy, non-addicted person might be able to handle without blinking an eye can feel catastrophic in nature to you.

If you’re new in your recovery, the coping devices you learned may feel non-existent, making it difficult to handle the situation. You may find it hard to step back and analyze the situation in a clear and calm manner. Instead, you might bail at the first sign of trouble and consider relapse as the best, if not only, solution.

Your ability to commit to your recovery steps is wavering.

It’s rare that a user can become sober and clean without getting professional help, such as what we offer here at 12 Keys Rehab. This is because you could be trying to self-treat years of addictive and out-of-control behavior. If you’ve already been through a recovery program and there is the potential for relapse, you may begin to make excuses as to why you are unable to attend meetings, why you left treatment early or why you quit counseling.

This lack of commitment to your steps in recovery can easily lead to relapse. Strong and true recovery takes years of hard, dedicated work with a consistent and ongoing sober program.

commitment to relapse

Signs of Suspected Alcohol or Drug Use

If you notice any of the following, your loved one may already be in relapse:

  • You find alcohol bottles or drug paraphernalia around the home.
  • Alcohol or medication are missing from the home.
  • Your loved one is intoxicated.
  • Money is stolen from family or friends or missing from bank accounts.

The Statistics of Relapse

You’re not the first person to have concerns about a loved one backsliding into addiction. More than half of those with a substance abuse problem return to addictive behavior — over 60% overall. Some drugs are more likely to cause relapse than others. People who use heroin, for example, suffer the highest risk of relapse at 91% — of those who relapsed, 59% started using again within one week.

heroin relapse

The NIH also found that certain factors — such as age, amount of use, method of administration and participation in aftercare — affected the likelihood of relapse. The most significant finding from the NIH is that people who get help and participate in aftercare are more likely to stay sober. Similarly, alcohol addiction is also likely to result in relapse, although rates vary significantly depending on the definition of remission as well as whether or not the individual gets help.

Why Relapse Happens: Biology

Addiction has been a problem faced by cultures around the world for thousands of years, from alcohol and marijuana to cocaine and morphine. Although all drugs and alcohol produce a “high” sensation, they each affect the brain in different ways.

Central nervous system depressants slow down functions such as breathing and heart rate while inducing relaxation and reducing anxiety. Central nervous system stimulants increase breathing and heart rate, often producing manic or excitable feelings. All substances — whether they stimulate or depress — negatively affect brain function.

nerves and chemicals in the brain

The nerves and chemicals in the brain help us learn, make decisions and feel pleasure. When we do something that feels good, the brain “records the experience”, according to Harvard University.

This powerful chemical reaction causes us to repeat actions that help us feel good. Nature intended our brains to use this chemical pathway to assure survival and reproduction; unfortunately, it was not prepared for us to use drugs or alcohol to circumvent the reward-takes-effort process. According to Harvard,

In nature, rewards usually come only with effort and after a delay. Addictive drugs provide a shortcut. Each in its own way sets in motion a biological process that results in flooding the [brain] with dopamine. The pleasure is not serving survival or reproduction, and evolution has not provided our brains with an easy way to withstand the onslaught. In a person who becomes addicted through repeated use of a drug, overwhelmed receptor cells call for a shutdown…The brain is losing its access to other, less immediate and powerful sources of reward…they want the drug even when it no longer gives pleasure.

In simpler terms, the brain of your loved one has learned that only drugs or alcohol can provide pleasurable — or even normal — feelings. The “addictive drug shortcut” also causes a more intense high than what healthy, responsible behaviors produce. At the same time this happens, your loved one’s brain becomes chemically unable to create happy feelings by engaging in positive behaviors that provide reward through slower means.

It can take years for the brain to relearn that non-addictive habits feel good. Although we don’t completely understand the science of cravings, we do know that this is — in part — why people relapse.

Why People Relapse: Behavior, Mental Health and Stress

If staying sober were as simple as waiting for the brain to heal itself, then there would be far fewer people addicted to drugs and alcohol. In addition to the chemical changes that take place in the brain concerning reward and learning, conditioned behaviors are also likely to trigger a relapse.

Your loved one likely associates certain people, places or events with using drugs or alcohol. That is why behavioral therapies — such as cognitive behavioral therapy — train the user to identify and avoid triggers that lead to using. These triggers might include seeing people who still use, going to a favorite bar or restaurant, or major life events such as a wedding or funeral.

There are other factors as well. If your loved one suffers from a mental health disorder such as depression, PTSD, ADD or ADHD, panic disorder or anxiety, he or she is more likely to use drugs or alcohol — especially if this condition has never been diagnosed or treated.

Suffering from addiction and a mental health disorder at the same time is known as dual diagnosis. In these cases, treating the addiction requires treating the disorder. Without addressing the underlying mental health issue, your loved one is much more likely to relapse.

stress is a leading cause of relapse

Your loved one might also be suffering under the weight of intense stress. Stress is a leading cause of relapse. For example, if the person you care about recently lost a loved one, went through a divorce or is having career problems, the urge to use might become overwhelming.

If you know your loved one is having a rough time, reach out. Not only can a well-timed phone call provide much-needed relief, you can also use the opportunity to encourage your loved one to get counseling or therapy.

Behavioral and psychiatric therapies — such as cognitive behavioral and psychotherapy — can help your loved one relieve stress. They can also shed light on why he or she started using. These therapies may not speed the biological healing process in the brain, but they can help your loved one deal with the underlying feelings that lead to using.

Your loved one may be trying to self-treat an overwhelming sense of sadness or anxiety with the instant false relief provided by alcohol or drugs. Behavioral and psychiatric therapies can teach your loved one how to recognize and address internal stressors with healthier actions and greater confidence.

Behavior and psychiatric therapies are also two of the most important ways your loved one can sustain sobriety after rehab ends. According to the National Institutes of Health and multiple additional sources, your loved one is much more likely to stay sober permanently if he or she makes counseling and/or therapy an ongoing part of life. That may mean attending meetings or private counseling sessions for years after having the last drink or dose of drugs. Since the temptation to relapse peaks at roughly six months beyond the first days of sobriety — and not the first few days, no matter how intense the urge to use may feel — counseling can be an invaluable weapon in the fight against relapse.

Why People Relapse: Genetics and Environment

Genetics Of Addiction

Perhaps the two greatest predictors of whether or not you will ever become addicted to drugs or alcohol are genetics and environment. People who have a close family member — such as a parent, grandparent or sibling — with addiction are 50 percent more likely to develop a problem themselves.

Keep in mind that this is not inevitable. Your loved one may have many family members addicted to drugs or alcohol, or he or she may be the only one.

Compounding the genetics issue is environment. The more time your loved one spends around alcohol or drugs — or with people who use alcohol or drugs — the more likely he or she is to start using again. That is why the behavioral counseling component is so important. During behavioral counseling, your loved one can develop the skills to avoid the people, places and activities that lead to using and relapse.

What to Do After a Relapse Happens

When Alcoholics Anonymous formed in the early 20th century, almost no one thought that addiction had a biological component. If you had a loved one who couldn’t stop drinking or doing drugs, it was because that person was morally weak or lacked the willpower to say no. Addiction was a disease that families hid from their friends.

Alcoholics Anonymous was the first time anyone ever tried to help a struggling addict. It is still the most successful recovery philosophy in the world. Today, treatment centers combine the principles of AA with the hard science we’ve learned over the past generation.

If relapse has occurred, do not give up hope. Instead, get your loved one into treatment.

couple consults at the psychologist

Most people who have been addicted to alcohol or drugs wind up relapsing at some point. Recovery is a lifelong journey; unfortunately, relapse seems to be one stop on the road to abstinence for many individuals.

Stay in touch frequently. Research clearly demonstrates that struggling addicts are more likely to get and stay sober permanently when they have the ongoing support of caring family and friends.

Your first move should be to talk to your loved one when he or she is sober and alone — or at least calm. Never approach someone who is clearly under the influence of drugs or alcohol to talk about sobriety.

Tell your loved one that you know he or she is using again. Ask him or her to consider going back to rehab. Avoid using judgmental language and statements that blame your loved one for the problem — even if you believe, deep down, that it’s his or her fault. Addicts are extremely sensitive people. When your loved one goes back into treatment, you’ll have plenty of time to address your own feelings of sadness, disappointment and anger.

If your loved one is unwilling to listen, it might be time to plan an intervention. An intervention can be an extremely powerful tool.

During an intervention, you and others who share your concerns will confront your loved one about relapse. You’ll express your wishes that he or she get help, too. The most effective interventions take place under the guidance of a professional interventionist who is prepared to escort the struggling addict to rehab. A professional interventionist will also plan and lead the meeting.

professional interventions

Poorly planned interventions can spiral out of control quickly, because the participants can be angry, anxious, emotional and stubborn. Having a professional interventionist there keeps the meeting moving forward and in control.

If you work with an interventionist to get your loved one back into rehab, you should plan that he or she will leave for residential care as soon as the meeting ends. If the meeting doesn’t go as planned, try not to despair. Many former addicts point to a “failed” intervention as a big reason they decided to get sober later.

Finally, if your efforts to convince your loved one to get help have not yet succeeded, don’t hesitate to join a counseling group or get therapy yourself. Living with an addicted person is extremely difficult.

It’s important to manage your own life and deal with your own feelings. So many of us let our lives revolve around the addicted person that we forget what it’s like to feel carefree and happy. Don’t let your loved one’s addiction ruin two lives — get help for yourself, too.

How Can I Prevent a Relapse From Happening?  

There are four primary ideas in relapse prevention that researchers from The Yale Journal of Biology and Medicine stress are important.

The first is to realize that relapse is a slow, ongoing process with certain stages. The objective of treatment is to help you or your loved one recognize the early stages, so there is a greater chance of success. The second is to understand that recovery involves developing milestones and personal growth, and that each milestone comes with its risk of relapse. The third is implementing relapse prevention tools like mind-body relaxation and cognitive therapy to help build those healthy coping skills needed to maintain sobriety.

The fourth idea of relapse prevention is to learn some essential rules of recovery. These are:

  • Create a new life where it’s simpler for you not to use
  • Be honest with yourself and others
  • Request help
  • Implement self-care
  • Stick to the program and don’t bend rules

Following these rules can help you stay focused and committed to your lasting recovery.

Know the Triggers and Warning Signs

A relapse can happen out of the blue, typically because you or your loved one was triggered. A trigger is something that causes you to feel justified in using again, such as a relationship, a certain event or an interaction.  It’s important to recognize relapse warning signs and triggers.

trigger categories

Each person’s trigger will be different. Your trigger, for example, might stem from an old memory, while a change in routine may lead someone else to relapse.

Some examples of common triggers include:

  • Dealing with negative emotions like anger, stress, depression, boredom, anxiety, loneliness, guilt or fear.
  • Going to events or locations that remind you of drinking or using.
  • Spending time with family or friends who drink or take drugs.
  • Being exposed to your drug or alcoholic beverage of choice.
  • Seeing an addiction object, such as a beer commercial or a syringe.
  • Having a positive emotional state, like having a good time and looking to enhance that feeling.
  • Experiencing peer pressure.
  • Using another substance that will eventually lead you to relapse.

When users are in early recovery, they are usually taught about the acronym HALT — hungry, angry, lonely, tired — which is where they are more susceptible to relapsing.

Other negative emotions like stress can make their cravings more intense. Uncomfortable feelings like anxiety, fear, anger, boredom, sadness and frustration are particularly difficult to experience during early recovery, which makes the user more tempted to use again to manage these feelings.

Once you’ve become addicted to alcohol or drugs, if you use again even once, you risk falling back into that addictive behavior and will likely lose control again — even if you haven’t used for a long time and have already been through treatment. Knowing this, what can you do to avoid relapse triggers?

Make a Relapse Prevention Plan

To avoid relapse, you need to have a solid plan in place immediately following treatment. This plan is something that you will likely work with a treatment specialist, such as one of the committed counselors here 12 Keys Rehab, to come up with.

solid intervention plan

So, when coming up with your relapse prevention plan, you need to learn and incorporate being able to regulate your emotions in the right manner and distract yourself.

This may include:

  • Exercising
  • Involving support groups
  • Listening to music
  • Reading
  • Meditating

You can also reduce your stress levels by following a daily, healthy routine. You should be getting enough rest, eating healthy and managing the little stressors in your day the right way. Once you’ve come up with your relapse prevention plan, you need to:

  • Commit to your treatment plan and stick with it no matter how stressful it can get. Keep your cravings under control by giving yourself distractions, continue going to support groups, seeing your counselor and taking any medication prescribed to you. You may feel you don’t have to continue these steps any longer because you have recovered, but following them will give you a much better chance of maintaining your sobriety.
  • Avoid triggers. Make new sober friends and stay away from your old drug-using crowd.
  • Get help immediately if you do begin to drink or use again. Contact your support network — this could be your sponsor, family or therapist — and ask for help.

Why Do I Keep Relapsing and What Can I Do to Stop?

Chances are if you have relapsed, you either don’t have a proper relapse prevention plan in place or you aren’t sticking with it. Even if you have relapsed, remember: You haven’t failed. You can pick right up where you left off. You’re probably scared and wondering where you should go from here, and these are natural feelings to have.

Reach out to Your Support System

Reach out to your sponsor or therapist right away so they can work with you to come up with an immediate plan of action. You may need to go back to a treatment program like 12 Keys Rehab or simply go to more therapy sessions and AA meetings every week.

don't be afraid to ask for help

Your relapse recovery activities will depend on your situation, but don’t attempt to do it alone. You likely came up with a support system while you were in treatment. Now it’s time to reach out to them for help. Your support team may have feelings about you relapsing, but you can admit to your mistake and assure them you are still on your path of recovery. Tell them you just need some support and encouragement during this time.

It’s not going to be easy coming back from a relapse, but this is where the coping skills you learned during your treatment come into play. This would be a good time to evaluate your situation and try to figure out what triggered you to relapse so you can learn from it.

Get Back to Your Relapse Prevention Plan

Just because you relapsed doesn’t mean you’re permanently broken — far from it. You just need to get back on track with your relapse prevention plan again. This means making that commitment again and starting fresh. Then you have to get your cravings under control.

Cope With Your Cravings

An important step in getting your cravings under control is to be positive and do a little backward thinking, such as:

  • Remembering how dark and depressing things seemed in your addictive behavior.
  • Remembering why you stopped drinking or using and the negative consequences that followed use.
  • Affirming to yourself that a normal part of your recovery is cravings — you just have to manage them and not give in to them.
  • Visualize your cravings as waves that roll in and out, and you simply have to ride them out.
  • Staying positive and remembering your successes every time a craving hits and seems overwhelming.

You have to remember your ultimate goal is lasting recovery. To achieve this goal, you have to actively build and implement safeguards since challenges will rise and you’ll have to work through them. You should recognize and celebrate small milestones. If you attend AA meetings, they are great for celebrating your milestones by handing out key tags, coins and other tokens for your sobriety time and sharing your success with others.

Don’t Quit on Yourself or Your Loved One

Whether you or your loved one is recovering from an addiction, keep in mind it may take more than one attempt. Relapse could happen more than once, but don’t get discouraged. You’ll stumble and fall, but it’s getting back up that counts. It’s important to realize that relapse doesn’t mean failure. In reality, it’s a common part of recovery. In fact, between 40 and 60 percent of people who had a drug addiction will go through a relapse during their recovery at some point, according to the National Institute on Drug Abuse.

And, if you do relapse, you’re not alone. You may have one or more relapses before you’re finally able to maintain a constant life of true sobriety. Substance abuse relapse rates are quite similar to those of certain chronic medical disorders like high blood pressure, asthma or diabetes.

The road to recovery is always open. You have to stay positive and determined when getting over obstacles to lasting recovery.

Help Your Loved One Through Addiction Recovery

Now that you know that relapse can happen and may occur during recovery, you can help your loved one get back on track quickly. This could mean talking to them about getting back into a recovery program like 12 Keys Rehab.

Your loved one may seem to have backslidden against their addiction, but you need to stay calm and supportive.

Learning how to react when a loved one relapses can be a challenge. Here are some tips to help:

  • Don’t panic. Don’t panic or feel hopeless or angry if your loved one relapses. Your main goal is to help them get back to their relapse prevention plan. Remind them that relapse is not the end of their recovery. The only thing that resets is their sober days. They haven’t lost everything they’ve learned and developed during their treatment. They just need to get focused again, which will require your support and encouragement.
  • Don’t blame. When your loved one relapses, you have to take out your positive tools, and blaming them is not one of them. It won’t help them or the situation and can even make them want to use more. At the same time, you shouldn’t blame the treatment program either, claiming it didn’t work. Relapse is a natural reality in recovery, unfortunately, and it doesn’t deserve blame or fingers pointed.
  • Stand firm. Remember the battle is your loved one’s. Knowing this will help you help them. For them to truly get better, they have to help themselves. You’re just there for support and guidance. This doesn’t mean you shouldn’t stand firm. You should hold your loved one accountable for their recovery from their relapse, just like you did when they were first starting off on their path to recovery. Don’t make excuses for your loved one or dismiss the problem. However, it’s also important that you don’t attempt to take on their problems either.
  • Be optimistic. Sure, relapse wasn’t the outcome either of you had hoped for, but it happened. At this point, you need to remain optimistic. By getting them back into an addiction treatment program, eventually, they can maintain an addiction-free life.
  • Get them the help they need. The absolute best thing you can do for your loved one is encouraging them to get back on the path of recovery. This will require more than just your help. It will require professional help, and it’s important that it starts immediately. In some cases, all that is needed is for your loved one to talk with their sponsor, go to 12-step meetings or go to counseling. In other cases, they may need more intensive care, and you can help get them into a treatment program like 12 Keys Rehab.

There’s No Shame in Relapse

If you did relapse, it’s not something you should feel bad about. It just means that something didn’t click in the previous attempt to recover. Treat it as a learning experience and try again.

While having a plan in place for preventing relapse is important, as you can see, it’s not always guaranteed. If you do relapse, it’s essential that you don’t allow emotions like shame, guilt, fear or anger overwhelm you. If you do feel these emotions, you have to deal with them promptly before they can trigger a full-blown relapse.

Use your coping skills you’ve learned to help deal with these emotions. Instead of getting angry with yourself, view your relapse as a sign that you need additional treatment. Getting professional help at 12 Keys Rehab could also identify an underlying health condition that is causing you to relapse, which your doctor can begin to treat. This is why it’s so important that you seek help and don’t try to manage alone.

lasting addiction recovery

Our staff here at 12 Keys Rehab is trained and experienced to treat all types of addiction, whether it’s alcohol or drugs. We are qualified and certified to treat dual diagnosis cases where you have an underlying medical condition along with substance abuse, by using treatment and therapy methods like Cognitive Behavioral Therapy, EMDR and our own 12-step model.

At 12 Keys Rehab, you’re not considered just a number. Your treatment plan is created and tailored specifically for your individual needs to ensure you have a successful recovery. Your treatment plan combines proven methods with customized-healing techniques to inspire confidence in your success.

Remember, hope is not lost if you have relapsed. It just means you may require a controlled environment for a little longer to help you uncover the cause of your relapse, prevent you from having another one and get you back on track on your journey to recovery.

Mistakes happen. Learn from them and keep moving forward. For holistic, real recovery focusing on science, spirit, body, and family, contact us here at 12 Keys Rehab by calling 800-338-5770 or completing our online form.

call today learn more view our programs

The Addiction Blog